To evaluate the effect of intravenous steroid and normobaric oxygen in the management of recent onset NAION.

In this randomized clinical trial, 90 eyes with NAION were randomized into 1-control, 2-steroid, and 3-normobaric oxygen therapy groups. BCVA was the main outcome measure, and MD, VFI and peripaillary retinal nerve fiber layer thickness (PRNFLT) were secondary outcome measures.

The baseline BCVA was 1.02±0.63, 1.05±0.7, and 0.76±0.5 logMAR in group 1, 2, and 3 respectively (P=0.293), which improved to 0.71±0.46, 0.73±0.36, and 0.59±0.41 logMAR at 6th month. The changes in BCVA were significant in control and steroid groups (P=0.039 and P=0.048 respectively). The MD at the time of presentation was 19.26±7.02, 20.51±4.68, and 19.3±7.17 in control, steroid, and oxygen group respectively (P=0.65). The corresponding values at months 6 were 18.42±8.17, 17.66±6.44 and 16.53±6.32 respectively (P=0.635). Baseline PRNFLT was 166±57, 184±57, and 193±65 micrometer (P=0.265); which decreased to 73±11, 87±26, and 79±19 at final follow up (P<0.001). There were no statistically significant difference between 3 groups in terms of final visual function and structure.

the results of our study suggest that IV steroid and normobaric oxygen do not improve structural and functional outcomes of NAION in comparison to placebo.